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If you’ve been on an antidepressant to treat depression for some time and are feeling better, you might start thinking about getting off that antidepressant.

The most important thing to remember? You need to consult your physician and map out a plan — a discontinuation approach — because you could experience negative effects and the risk of a depression relapse.

"Once patients have decided that they want to try to discontinue use of antidepressants, they should work on a discontinuation approach with their physician,” explains Michael First, MD, a professor of clinical psychology at Columbia University Medical Center in New York. In most cases, this involves gradually tapering off the medication.

“Patients should not abruptly stop taking their medication, especially with certain medications, like SSRIs [selective serotonin reuptake inhibitors] or SNRIs [serotonin-norepinephrine reuptake inhibitor], as they can cause a very uncomfortable discontinuation syndrome,” says Dr. First. Prozac is the only exception; this SSRI depression drug is very long-acting and, when you stop treatment abruptly, the body naturally tapers the medication stored in the body over a four- to five-week period, he explains.

According to First, the speed at which depression drugs can be withdrawn varies — some people are very sensitive to discontinuation syndrome, while others don’t experience unwanted effects. Another reason to taper the medication rather than stopping it cold-turkey is that tapering the medication may reduce the risk of relapse, First says.

Are You Having a Depression Relapse — or Discontinuation Syndrome?

It can be easy to mistake discontinuation syndrome, which is associated with stopping antidepressants, with a relapse of depression or even an illness. “If one is going to get depressed again, it is unlikely that it will happen immediately after medication is stopped,” says Justin Schechter, MD, a psychiatrist in private practice in Stamford, Conn. A return of depression usually occurs months after medication is stopped and can also be provoked by an environmental stressor.

“Discontinuation syndrome typically appears when you get near the end of the tapering schedule — that is, when you are at the lowest levels of the medication,” First explains.

Common symptoms associated with discontinuation syndrome include feeling dizzy, achy, tingling, nauseated, and fatigued, much like having the flu. An easy way to tell if you’re going through discontinuation syndrome is to take a dose of the medication that you're tapering from. “If the symptoms go away within a couple of hours, then they’re from discontinuation, rather than something else, like from a virus,” First says.

How to Prevent Discontinuation Syndrome

To avoid discontinuation syndrome, Dr. Schechter says that in addition to tapering off depression drugs slowly over the course of several weeks, you can use over-the-counter remedies to combat physical symptoms — such as ginger root capsules at a dose of 200 mg three times daily to treat nausea and dizziness. It’s also important to maintain contact with your doctor during the tapering off process for support and guidance.

"Other alternatives to maintain good mood for patients who are discontinuing antidepressant treatment include psychotherapy and exercise,” First says. If you’ve been undergoing psychotherapy or exercising while on an antidepressant, it’s important to continue with these approaches when discontinuing drug treatment. “Both psychotherapy and exercise have been shown to have beneficial effects in patients who were depressed,” he adds.

The only way to really tell if you no longer need depression drugs is by stopping antidepressants. Unfortunately, it is very difficult to determine if someone on an antidepressant for the first time will be able to come off the medication or will relapse, First notes.

"For patients who repeatedly relapse when they go off their medication, it is often best for them to stay on the medication indefinitely to keep their depression from relapsing,” he says. “Some may need to be on antidepressants chronically, which is simply a fact of life and should not be viewed as some sort of failure on the part of the patient.”

Furthermore, there’s no evidence that remaining on antidepressants for life has any negative, long-term effects. Says First, “this is an individual decision that each patient needs to make — to decide if they are doing better on the drug or could go without them."

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